Hospitals will test tender ears

Screening infants will allow early diagnosis, treatment

Benjamin J. Dubin first suspected something was amiss when his baby daughter, Rachel, didn't respond to the musical mobile above her crib and sometimes seemed not to hear her parents' words.

But it wasn't until Rachel reached age 4 that the Baltimore County girl's hearing was tested, revealing that she was deaf in one ear and severely hearing-impaired in the other. She had had the hearing loss since birth, and Dubin wishes it had been diagnosed earlier so that doctors could have started treatment immediately to prevent problems she had with speech development.

Hospitals are gearing up to make sure that cases such as Rachel Dubin's don't occur again. A state law requiring the testing of infants' hearing within 48 hours of birth goes into effect July 1.

"The little bit of money it costs is going to save society a lot," said Benjamin Dubin, 58, an accountant who is national treasurer of the Alexander Graham Bell Foundation, which has pushed for mandatory screening of infants' hearing.

"Early intervention is going to make these kids very productive," said Dubin, whose daughter Rachel, 23, recently earned her master's degree in international studies at George Washington University. "And there's going to be no limit to what they can accomplish."

Maryland's legislation, passed last year, requires every hospital to screen newborns for hearing problems and requires health insurance companies to cover the test, which costs $20 to $40. Twenty-seven states require such tests, and legislation is pending in nine.

The test, which takes 30 seconds to two minutes, is performed on all newborns in a handful of hospitals across the state, including St. Joseph Medical Center in Towson and Holy Cross Hospital in Silver Spring. Other hospitals test only high-risk babies, those with a history of hearing impairment in their families, low birth weight or genetic birth defects connected with deafness.

Audiologists or technicians conduct the test using hand-held devices known as otoacoustic emissions probes to send a sound into a baby's ear. They wait to see whether the sound reverberates through the ear canal and sends a signal back to the device. If the baby fails the test, audiologists usually repeat the screening the next day before deciding whether further tests are needed.

W. Stephen Seipp, a Lutherville-based audiologist who has conducted infant hearing screenings at St. Joseph Medical Center for 18 months, estimates 10 percent of babies fail the test the first time. In the end, about 1 percent of babies tested have hearing loss.

At St. Joseph, Paul Teie, an audiologist who works with Seipp, said that of the 3,300 babies tested there in the past 18 months, hearing problems have been diagnosed in two. He said that proportion is below average.

In pushing for the mandatory testing last year, doctors and parents argued that such screening would identify hearing problems in children earlier and allow them to start treatment sooner.

They also argued that the costs of the test are outweighed by the millions of dollars the state would save in educating hearing-impaired children whose speech and reading development might have been hindered by late detection.

Seipp said that without the infant screenings, hearing problems often are diagnosed only when children enter preschool or elementary school, and teachers notice that they can't follow along in class.

Karl White, director of the National Center for Hearing Assessment and Management at Utah State University, said research has found that as much as $400,000 per child can be saved in special-education costs if early detection enables them to develop at the same pace as nonhearing-impaired children.

For parents, the tests often provide quick answers for some of the questions and worries that a newborn brings into their lives. Cheryl McCleary-Bowser, 38, a marketing associate who lives in Upper Marlboro, remembers worrying about whether her 4-year-old son, John, had hearing problems during his early years.

"When he was 5 months old, I remember doing little tests, like clapping my hands around him, trying to see if he could hear," she said.

When her daughter, Jaelyn, was born six weeks ago, she had the same worries. But this time, she didn't have to do any clapping.

Seipp had begun conducting dry runs of the infant hearing screening last week at Anne Arundel Medical Center, one of four hospitals that his company, Hearing Assessment Center, is preparing for the mandatory tests.

McCleary-Bowser signed Jaelyn up for a test and went to the hospital in Parole on Thursday.

Watching Seipp insert the tiny probe into the sleeping Jaelyn's ear and then waiting as the seconds ticked by, McCleary-Bowser nervously asked, "Isn't she supposed to wave or raise her hand or something?"

Within minutes, Seipp completed the tests and announced that Jaelyn had passed.

"When you leave the hospital, there are so many things you worry about," McCleary-Bowser said. "It's good to have one more piece of information that things are going fine."